Grey-scale ultrasonography in the differential diagnosis of jaundice

One hundred fifty patients with cholestatic jaundice were studied prospectively by grey-scale ultrasonography. All patients had a diagnosis established by subsequent biopsy, autopsy, or surgery. Using the presence or absence of a dilated biliary tree as the criterion, the intrahepatic or extrahepatic nature of the jaundice was correctly differentiated in 145 of 150 patients, an accuracy of 97%. All 64 of the patients with intrahepatic jaundice were correctly identified. Five of the 86 remaining patients, each of whom had gallstones, were misdiagnosed. In eighty-two patients (54.7%), the specific etiology was diagnosed. Ultrasound is an accurate method for the evaluation of jaundice and would appear to have a definite value as a screening procedure before proceeding to more invasive studies.